Computer Related Injuries

In today's working environment the number of people working on PCs has increased rapidly. A recent survey found that there are 5•5 million display screen equipment operators working in the UK- one quarter of the work force. Computer related Health and Safety is therefore of prime importance. Computer power allows workers to increase productivity. However, this also tends to increase monotony, muscle strain and fatigue. In addition, computers make it possible to cut the work breaks and increase the pace of work. This leads to injuries associated with computer use become more pronounced. We still not know the full, long term consequences of a working lifetime of computers because computer technology has not yet been around long enough. What are do know is that users are suffering from a range of injuries associated with computer use and that they are all preventable.

Computer related injuries cover a wide variety of health problems caused by or contributed to by computer usage. These can be broadly divided in to three goups. (1)Repetitive Strain Injuries (RSI) (2)Back Problems (3)Eye Strain & Discomfort

Repetitive Strain Injuries (RSI) -also known as Work Related Upper Limb Disorders (WRULD) this is a non medical term used to describe the many types of disorders associated with performing the same repetitive task, especially in an awkward posture over a prolonged period of time. RSI is not a modern problem. In 1713 the Italian physician Benardino Ramazzini recorded that the incressant hand movements of clerks caused ‘maladies’. In the 1840's there was an epidennic of writers cramp among service clerks in London. The term RSI was introduced in Australia in the 1970's with the introduction of VDU's (Monitor) in to the workplace. Repetitive Strain Injuries occur from repeated physical movements doing demage to tendons, nerves, muscles and other soft body tissues. Occupations ranging from meat- packers to musicians have characteristic RSIs that can result from the typical tasks they perform. The rise of computer use and flat, light-touch keyboards that permit high speed typing have resulted in an epidemic of injuries of the hands, arms and shoulders. Use of pointing devices like mice and trackballs are as much a cause, if not more so. The thousands of repeated keystrokes and long periods of clutching and dragging with mice slowly accumulated damage to the body: another name for the condition is Cumulative Trauma Disorder. This can happen even more quickly as a result of typing technique and body positions that place unnecessary stress on the tendon and nerve in the hand, wrist, arms and even the shoulders and neck. Lack of adequate rest and breaks and using excessive force almost guarantee trouble. The two most common forms of RSI are Carpal Tunnel Syndrome and Tendon Injuries. Carpal tunnel syndrome is caused by irritation and compression of the median nerve at the wrist. Constant flexing and compression of the wrist casues compression of the median nerve, eventually transforming into fibrosis (tough iflexible tissue). This can lead to constant pain in the wrist, numbness and pins and needles which may prevent full mobility in the hand. While, tendon injurie come in two forms—Tendonitis and Teno-synovitis.

Tendonitis is inflammation of tendons. Repeated tensing of a tendon causes inflammation. Eventually, the fibres of the tendon start separating and can even break, leaving behind debris which induces more friction, more swelling, and more pain. “Sub-acute” tendonitis is more common, which entails a dull ache over the wrist and forearm, some tenderness, which gets worse with repetitive activity.

Tenosynovitis is an inflammation of the tendon sheath. Chronic tenosynovitis occurs when the repetitive activity is mild or intermittent: not enough to cause acute inflammation, but enough to exceed the tendon sheath's ability to lubricate the tendon. As a result, the tendon sheath thickens, gets inflamed and causes pain. Both of the above cause pain with movement of the fingers. Pain is also felt over the top of the hands and knuckles as the condition worsens, possibly even leading to a burning sensation in the forearm.

The incidence of RSI is increasing rapidly. A survey conducted in 1998 states that RSI has increased by 22% in the last two years. Over 100,000 computer operators are affected by RSI every year and one in three workplaces are affected. These are starting statistics leading to claims that RSI will be industrial plague of the 21st century. RSI is very easy to prevent. Unfortunately it is very hard to cure. Preventative measures are more cost effective and work. Curative measures are unreliable and extremely expensive. Back Problems-Musculoskeletal back problems are the largest cause of disability amongst people of working age. 30% of adults become chronic sufferers. The highest incidences of back pain are found in workers whose jobs are entirely sedentary or entirely manual. The human body is not designed to remain in a sedentary position for long periods of time. Unformately most VDU (Video Disply Unit) user to occupy sedentary positions for the majority of their working day. The sedentary position occupied whilst using a computer is not good for a users back and many office workers suffer from back pain. The problem is exacerbated if the user has a low general level of fitness. The pain started to cause loss of sleep and an inability to carry out normal household tasks changed working practices would have prevented this problem occurring. They are now helping reduce the pain experienced. Eye Strain & Discomfort-People who use VDUs for extended periods of time can suffer from tired eyes, discomfort and head aches. 70% of display screen operators complain at some stage in their working lives of discomfort around the eye region. Staring at a screen can lead to a drop in blink rate causing dry eye. Undertaking more demanding tasks with your eyes can cause headaches and users may become aware of an eyesight problem they had not noticed before. There is no evidence that using VDUs causes permanent damage to eyes. The impact of any serious injury caused at work creates a dramatically negative effect on the overall performance of the company itself. Pain experienced at work immediately affects both the morale and the productivity of employees. Poductivity decreases.

What should we do-Slight changes in working practices can have a dramatic effect in reducing risks and aches and pains associated with computer use. (i) Active posture Good posture is not just sitting up straight. A good posture is one which most naturally suits your body. This means that your back should be in a slight S-shape with your shoulders up and your head straight. You should not be hadched over nor have your head tilting down at a sharp angle. Your arms and fingertips should be horizonatal and level with your desk top. The back rest of your chair support your lower back and you should sit with your back against it. Your eyes should point slightly downwards to the middle of your computer screen. Adjust the height of the screen accordingly. Your legs should be horizontal on the seat of your chair or should point slightly downwards at the knees to encourage a good posture. If your feet do not touch the floor, a foot rest should be used to support your legs. Try to become more aware of your posture and keep reminding yourself to sit properly. Changing your body position regularly keeps your back, neck and body mobile and free from stiffness. (ii) Taking regulars breaks The way you work affects your health and in turn affects your work. Taking regular breaks is essential to relieve the body: From the strains imposed by the continuous repetitive movements of using a keyboards and mouse. From the sedentary position we all occupy when working at our computer. Even with the best possible posture and a perfect ergonomic workstation we will still harm our bodies if regular breaks are not taken. For good health, your should develop a routine which involves taking regulars breaks fom computer work. Frequent short breaks are much better than longer breaks at less frequent intervals. During a break it is important to relax your eyes by looking away from the screen and relieve the stress on your body by relaxing your hands, arm and shoulders. Ideally you should move from your seat. Regular stretching exercise will stimulate blood flow and help prevent the build up of aches and pains. It will also stimulate the mind! A range of suggested exercises are suggested in ScreamSaver. Remember that you should not look at the screen whilst undertaking the exercises.

Indian Scenario- The pattern and nature of CRI in India is significantly different from that in the West. What may work may be a disaster here. There may be significant anthropological difference in body shape and dimensions, work practices and furniture design that only a comprehensive study can unearth. As these problems are unique to our country, so should the solutions. According to a research conducted on 650 subjects in computer-dependent careers it was by a Bangalore based Orthopaedic Surgeon Dr. Deepak Sharma revealed that 55 per cent of subjects developed symptoms within a year of starting computer dependent careers. 76 per cent reported having at least one symptom, while 60 per cent of those with severe injuries recalled having chronic neck and shoulder pain or stiffness that they had considered ‘normal’ for computer users. Six software engineers between 25 and 35 had to give up their careers due to CRI symptoms. Also, it was found that the best-known CRI, Carpal Tunnel Syndrome, is actually very rare in India. Awareness about CRI is largely lacking amongst computer users and medical professional in India. Early symptoms are ignored or treated inappropriately, often leading to a situation when it is impossible to work productively any longer. In another survey of 500 software professionals at Hyderabad shows that 50% had symptoms of established CRI. Preliminary results of ongoing survey among over 400 IT professionals in Bangalore (2001-2002) shows that 75% had symptoms of established CRI. Eventually, we can say that the awareness is only prevention of computer related injuries. Appropriate changes can make the difference.

What is ScreamSaver-ScreamSaver is essential for best practice computer use. It is an inexpensive, fully automatic software solution to the fastest growing workplace health risk. A perfect ergonomic workstation alone can't prevent RSI. To avoid injury, computer users must maintain good posture, get appropriate exercise and take frequent, regular breaks from keyboard and mouse. ScreamSaver provides the reminder to the user, without which he or she is unlikely to take these breaks. There are risks inherent with using computers at work. The ScreamSaver Computer Safety Training educates users of these risks and how to avoid them. Just training users of the need to take breaks has very limited effectiveness. The training material is soon relegated to the bottom drawer and the training forgotton after a month or so. ScreamSaver cannot be relegated to the bottom drawer. It is proactive reminder to users. It is not just about prompting users of the need to take breaks but of the need to look after themselves whilst using their computers. It is a reminder to attain the correct posture and vary tasks. ScreamSaver provides an informative suggested exercise screen for users. ScreamSaver is promoting a healthier working environment and work force. ScreamSaver computer safety training contains all the information users need to undertake computer work safety easily accessible to all users. ScreamSaver can be used to log the breaks of individual users. The powerful search engine can then be used by the network administrator to target those users who are not taking adequate breaks. The information contained within these log files provide an important tool should the employer have to defend against compensation claims. Condition of law at abroad-All the regulations derive from the common Health and Safety principle of eliminating the source of an identified risk. Where risk is unavoidable it must be evaluated and measures taken to reduce it to an acceptable level. The 1992 DSE Regulations lay down the following area of resposibility. 1. All computers must fit a minimum specification for healthy use. 2. All workstations must be assessed for risk. 3. Computer equipment must be fit for the job to avoid strains and discomfort. 4. All users must be made to take regular breaks from computer work. 5. Eye tests and special glasses must be provided if requested. 6. Training on computer safety must be provided to all computer users. 7. Users must be given relevant information relating to their health and safety. The pattern and nature of CRI in India is significantly different from that in the West. What may work there may be a disaster here. There may be significant anthropological differences in body shape and dimensions, work practices and furniture design that only a comprehensive study can unearth. As these problems are unique to our country, so should the solutions.According to a research conducted on 650 subjects in computer-dependent career it was by a Bangalore based Orthopedic Surgeon Dr. Deepak Sharma revealed that 55 percent of subjects developed symptoms within a year of starting computer dependent career. 76 percent reported having at least one symptom, while 60 percent of those with severe injuries recalled having chronic neck and shoulder pain or stiffness that they had considered "Normal" for computer users. Six software engineers between 25 and 35 had to give up their careers due to CRI symptoms. Also, it was found that the best-known CRI, is actually very rare in India.Awareness about CRI is largely lacking amongst computer users and medical professional in India. Early symptoms are ignored or treated inappropriately, often leading to a situation when it is impossible to work productively any longer.In another survey of 500 software professionals at Hyderabad shows that 50 percent had symptoms of established computer related injuries.Preliminary results of ongoing survey among over 400 IT professionals in Bangalore (2001-2002) shows that 75% had symptoms of established CRI.Eventually, we can say that the awareness is only prevention of computer related injuries. Appropriate changes can make the difference.
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